We’ve answered some questions about the Health Plan benefits and premium changes effective from your policy anniversary either on or after 1 September 2025. Not sure when your anniversary is? Log in to the online Member Portal for information about your policy and a copy of your most recent Health Plan and policy certificate.
Premium
How often are premiums reviewed?
Every year, we review our premiums and Health Plans to ensure they remain up-to-date, sustainable and continue to deliver value for the health and wellbeing of our Members. Changes are then effective from your next policy anniversary on or after 1 September.
What factors are considered when reviewing premiums?
When we review our premiums, we consider a range of factors such as procedure and treatment costs, utilisation across different types of Health Plans (the frequency at which Members use the benefits on their plans), market conditions, general and medical inflation, and Health Plan changes.
Medical inflation is when the price of healthcare services, treatments and products increases. In recent years this has increased significantly, well outpacing general inflation.
Why are premium increases larger this year than in previous years?
Premiums are driven by two key factors: the cost of treatment and procedures (such as surgeries or cancer treatment); and the number/size of claims, neither of which are within UniMed’s direct control.
The cost of medical treatments and private hospital services has increased significantly in recent years, well outpacing general inflation. The number of claims we receive has also been increasing significantly.
The risk of claiming also increases with age, so this is another factor in calculating premiums. Premiums for each age group reflect the historical and expected claims for that group. As people age, they are more likely to use their insurance, and over time treatments become more expensive.
As a result, we must increase our prices to ensure that we are able to continue to support our Members and pay out claims into the future.
Has the transfer to UniMed impacted premium increases this year?
Health Plans originally issued under the Accuro brand have faced the same impacts as those issued under UniMed in terms of the increasing cost of treatment and procedures, and the increasing number of claims.
This situation is not unique to UniMed – all private health insurers in New Zealand are facing similar challenges and unfortunately this means that premiums are rising across the industry.
How are premium increases applied?
We consult with external professional actuaries who review independent data on healthcare costs, help predict future costs and utilisation, and provide an objective view on whether pricing is fair and commercially sound. Increases are applied consistently across Members on the same plans.
What will premium increases look like in the future?
Over the last few years, UniMed dipped into reserves to help minimise premium increases for Members in the hope that the market would stabilise. This has not been the case and unfortunately we have no choice but to put through larger increases this year to ensure that we have enough income to cover claims into the future.
We have introduced some elements this year designed to help manage costs, including introducing a lifetime limit of $200,000 on spinal surgeries going forward, which are some of our most expensive procedures.
We will also be continuing to enforce reasonable charges (previously reasonable and customary charges) on our service providers.
Where does my premium go?
As a not-for-profit society, our core purpose is to keep working New Zealanders and their whānau in lifelong good health. The vast majority of premiums received goes towards paying claims, with the remaining being used to operate UniMed and to fund investment in future services and technology to improve efficiency.
Will my premium increase even if I haven’t made any claims recently?
Health insurance is based on the idea of risk pooling – this means that everyone pays into a shared fund and the financial risk of high medical costs is spread across the whole group.
Your premiums cover the cost of providing protection and access to cover if or when you need it, whether or not you make a claim.
When will my premium change?
You will receive your annual renewal notice containing your updated premium, Health Plan document, Summary of Health Plan Changes, and policy certificate 30 days before your anniversary date.
What options are available to help manage my premium?
We may have alternative options you can consider to help manage your premium, such as:
- Increasing your excess – read more here
- Removing people or plans
- Downgrading your cover.
Please get in touch with us for more information. We recommend discussing with your financial adviser if you are considering changes to your plan.
Can I put my premium on hold?
If you are facing redundancy or financial hardship, we can support you with options for retaining your health insurance.
UniMed can offer a suspension period of up to 12 months. This means that your policy will be put on hold – you won’t have a premium to pay, but no claims can be made for procedures or treatment during this time. You can always come off suspension early should you need to claim.
More details about suspensions can be found in your Health Plan document (policy document) or contact our team directly to discuss suspension options.
How do I cancel my policy?
You can request to cancel your policy in writing (by email or letter) or by phone.
If you cancel your policy and wish to start a new one at a later date, the same level of cover and premium as you have now cannot be guaranteed. New exclusions and no-claim periods for pre-existing conditions may apply and you will lose any loyalty benefits for which you were eligible.
Health Plan benefits
What benefits are changing?
Every year, we review our Health Plans to ensure they remain up-to-date, sustainable and continue to deliver value for the health and wellbeing of our Members.
When you receive your annual renewal notice, this will include a summary of changes to your Health Plan, effective from the date your policy renews on or after 1 September 2025.
What benefits are being introduced?
This year, we are pleased to be introducing a range of proactive health benefits to help support you before, during and after you need medical treatment.
- Mental health support
- Coaching programme for people living with cancer
- Nutrition support
- Fitness and recovery support.
These benefits are in the process of being implemented and we will share more information on our website when they are ready to roll out.
In my Summary of Health Plan Changes, it mentions ‘reasonable charges’ - what does this mean?
Our reasonable charges (previously reasonable and customary charges) make sure that healthcare providers are fair with the amount they charge for medical treatment or procedures. We will continue enforcing reasonable charges on our service providers.
I have the Specialist module, don't I already have a Mental Health benefit?
In our latest benefit changes, we have added a Mental Health benefit of up to $1,000 on the base plan of all of our Health Plans as a standard benefit.
We have also retained the Mental Health benefit on the Specialist module available on some of our Health Plans*.
This means that there is up to $2,000 available for Mental Health consultations depending on your plan and eligibility.
For full terms and conditions, please see your Health Plan document and policy certificate.
*Specialist module applicable to SmartCare, SmartCare+, KidSmart, SmartStay, StaffCare, StaffCare+ and StaffStay.
General
Does my premium contribute to Member Offers?
We offer a range of Member Offers through our trusted partners to support your health journey. These are available to all Members and do not impact your premium. Current offers are:
- 15% off travel insurance with Allianz Partners
- 20% off MoleMap checkups
- Free hearing health checkups with Bloom Hearing Specialists
- Offers at Specsavers Optometrists
Where can I find more information about Accuro becoming UniMed?
We’ve set up a web page with more information about the transition to the UniMed brand. Please go to unimed.co.nz/accuro for regular updates.